Anatomy

Question 1

What are the functions of the prostate?

Answer 1

Store and secrete a fluid that nourishes sperm

Question 2

Where is the prostate located?

Answer 2

Inferiorly and posteriorly to the bladder
Anterior to the rectum
It surrounds the prostatic urethra

Question 3

What is the purpose of the testes (plural)?

Answer 3

To produce sperm and testosterone

Question 4

What is the function of the vas defernes?

Answer 4

To carry sperm from the epididymis to the ejaculatory duct

Question 5

What is the function of two ejaculatory ducts?

Answer 5

To pierce the upper posterior surface of the prostate, and open into the prostatic urethra

Question 6

What are the seminal vesicles?

Answer 6

They lie on the posterior surface of the bladder and secrete thick fluid into the ejaculatory duct , which mixes with sperm

Question 7

Where are the bulbouretural glands located and what is their function?

Answer 7

They’re located within the external uretral sphincter. They secrete a mucus -like fluid into the urethra during sex

Question 8

What is the anatomy of the prostate?

Answer 8

It’s surrounded by a fibrous capsule → which in turn is enclosed in a fibrous sheath
The prostatic plexus of nerves and veins (continuation ‘ of the lower part of the pelvic plexus) sits within facial shell of prostate and innervates the urethra and penis

Question 9

Why is nerve - sparing important?

Answer 9

To prevent erectile dysfunction and bladder incontinence issues

Question 10

What are nerve fibres?

Answer 10

The smooth muscle of the prostate is innovated by sympathetic and parasympathetic nerve fibres

Question 11

What are sympathetic nerve fibres and their function?

Answer 11

( T12 & L1) → inervate the prostate via the hypogastric and pelvic plexuses. This triggers smooth muscle contraction during ejaculation

Question 12

What do sympathetic nerves cause?

Answer 12

The internal urethral sphincter contract → preventing backflow of fluid into the bladder and inntervate the was deferents to contract and propel sperm to the urethra

Question 13

What are parasympathetic nerves

Answer 13

Less important in prostate anatomy → these nerves innervate the penis

Question 14

What is the prostate gland structure?

Answer 14

Is divided into 5 lobes embedded within the smooth muscle and connective tissues of the gland

Question 15

What are the 5 lobes

Answer 15

Right and left lateral → rich in glands
Anterior → no glandular tissue
Median → rich in glands
Posterior → rich in glands

Question 16

What 4 zones are the prostate divided into?

Answer 16

Anterior
Central
Transition
Peripheral

Question 17

What is the anterior zone?

Answer 17

The fibromuscular stoma → and is mainly muscle tissue

Question 18

What is the central zone?

Answer 18

It surrounds the ejaculatory ducts

Question 19

What is the transition zone ?

Answer 19

It surrounds the urethra → the glands of TZ are often those affected by benign prostatic hyperplasia

Question 20

What is the peripheral zone?

Answer 20

Makes up the main body of the prostate gland (65%). The ducts of the PZ empty prostatic fluid into the prostatic urethra.
70% of cancer stems from this zone

Question 21

What is the anatomy of the prostatic urethra?

Answer 21

3 cm long
Commences at the neck of bladder
Passes through the prostate from the base to the apex, and becomes continuous with the ‘membraneousurethra’
•The Prostatic Urethra is the widest and most dilatable part of the entire urethra.

Question 22

What are the routes of spread?

Answer 22

Local invasion
Vascular spread
Lymphatic spread

Question 23

What is local invasion?

Answer 23

Where the tumour may grow larger → enough to grow through the prostate capsule and invade nearby structures. Including :
Bladder
Urethra
Seminal vesicles
Urinary sphincters
Rectum

Question 24

What is vascular invasion?

Answer 24

Where the cancer spreads through the blood supply

Question 25

What arteries contribute to vascular spread?

Answer 25

Inferior vesicular artery Pudendal artery and the middle vectal artery, which are supplied by the internal iliac artery

Question 26

What veins contribute to vascular spread?

Answer 26

The blood is received from the dorsal vein of the penis and many vesicular veins that drain to the internal iliac veins. Veins from the prostatic venous plexus→located between the capsule and fibrous sheath Prostatic venous plexus is continuous superiorly with the vesical venous plexus and posteriorly with the inner venous plexus

Question 27

What is lymphatic spread

Answer 27

Where primary vessels from the prostate drain into regional lymph nodes of the pelvis. On occasion metastasis goes beyond regional lymph nodes → involving distant lymph nodes outside the pelvis

Question 28

What are the regional lymph nodes?

Answer 28

Internal iliac ( hypogastric) nodes Pre - vesical modes Obturator nodes Pre- sacral nodes External iliac nodes

Question 29

What are the distant lymph nodes?

Answer 29

Superficial and deep inguinal nodes Aortic nodes Common iliac nodes

Question 30

What is the percentage of metastasise occurs in bones?

Answer 30

85% - 90%

Question 31

What are the less common sites of metastasise?

Answer 31

Liver lung Brain